Contributor: Thomas Frazier, II, PhD
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A lack of speech is one of the biggest anxieties parents have about children with autism.
In some cases, when a child is struggling to develop verbal skills, help comes in the form of technology. Speech-generating devices have long been available for children with autism, and the era of tablets and apps has expanded those options.
Below are four common questions about speech-generating devices and apps, with helpful answers and insight from Allison Acerra, a speech therapist at Cleveland Clinic’s Center for Autism.
Who needs a speech-generating device?
There’s no one-size-fits-all answer to this question. You’ll want to work closely with a speech therapist to get the right answer for your child.
“Look for apps or devices that can expand as your child’s skills grow.”
Thomas Frazier II, PhD
Director, Center for Pediatric Behavioral Health, Center for Autism
This expert will assess a number of questions. What level of verbal skills, if any, does your child have? Have you tried other forms of communications, such as gestures or pictures? What progress has your son or daughter made in speech therapy?
It’s a complicated decision, but that’s why we’re so thorough in making it. For example, at our center, we typically do test runs with three different devices to help find the right fit for a child.
What are your options?
Many parents still turn to dedicated speech-generating devices. But tablets with apps such as Proloquo2go and TouchChat are viable options, too. Insurance coverage varies, so talking to your insurer about what’s covered may play a part in your decision.
Perhaps more important, though, is finding a device or app that works for your child now and will grow with them in the future. That’s why hands-on trials are so helpful.
For example, lower-functioning children with motor skill issues need a simple setup: a large screen with a few easy-to-press buttons. These buttons represent simple requests: going to the bathroom, asking for food and so on.
However, look for apps or devices that can expand as your child’s skills grow. That simple food button may later need to become a sub-menu of different types of food as a child’s knowledge develops.
Likewise, moderate-functioning children might need something more robust. Instead of buttons that relay simple requests, they may require the ability to type full sentences.
How can you encourage your child to use a speech-generating device?
The best approach starts in school or therapy.
If your child is in a program that uses applied behavior analysis (ABA), you probably are already familiar with prompting and reinforcement. Simply apply those skills to device or app use. Treat it like any other behavior they need to learn.
Here’s an example: If you’re trying to help your child practice requesting food, set out a plate of his favorite cookies. If he uses the device to make a request, use the cookies as a reward. If he just automatically grabs the cookies, walk through the process of using the device with him before he eats the cookie. But try to do so nonverbally, through a demonstration rather than an explanation.
Encourage the use of devices or apps out in the world, too. We find they’re often a way for children to break the ice with others. Neurotypical children may take an interest once they see a child using an iPad to “talk,” for example.
Will using a speech-generating device make your child less likely to speak?
This is a common misconception. But data and experience both suggest it’s not true.
In reality, speech-generating devices and apps help children practice the use of communication. In higher-functioning children, they are sometimes even a gateway to different forms of communication. But even when that’s not the case, with the right device or app, a child can learn to express himself or herself better — and that’s a major step toward developing functional life skills.